4621 Beacon Hill Rd - COCCity of Baran
Property Address:
City Approved: 4.c.)
Print name
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eapll
City of Eagan, Minnesota al/
COMPLIANCE WIIH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 1 / t , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC LIVE WORK PERFORMED
n Ihis is to certify that the property listed above has been found to be in compliance with Section 3 40 of the City Code
after satisfactorily completing the requited corrective repair work under (check all that apply):
n City Sanitary Sewer Permit City Plumbing Permit
NOTE.: Applicable only if box is checked: FiBased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed to minimize apotential blockage due to.'
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
1----1
Signature
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 .23 2010